Avoidance of Antibiotic Treatment for Adults with Acute Bronchitis (AAB)
The percentage of adults 18-64 years of age with a diagnosis of acute bronchitis who were not dispensed an antibiotic prescription. A higher rate indicates appropriate treatment of adults with acute bronchitis.
Antidepressant Medication Management (AAM)
Assesses different facets of the successful pharmacological management of major depression.
Optimal Practitioner Contacts for Medication Management. The percentage of members 18 years or older who were diagnosed with a new episode of major depression and treated with antidepressant medication, and who had at least three follow-up contacts with a practitioner during the 84-day Acute Treatment Phase.
Acute Phase Treatment. The percentage of members 18 years or older who were diagnosed with a new episode of major depression, were treated with antidepressant medication, and remained on an antidepressant drug during the entire 84-day Acute Treatment Phase.
Continuation Phase Treatment. The percentage of members 18 years or older who were diagnosed with a new episode of major depression and treated with anti-depressant medication and who remained on an antidepressant drug for at least 180 days.
Use of Appropriate Medications for People with Asthma (ASM)
The percentage of members 5 - 56 years of age who were identified as having persistent asthma and who were appropriately prescribed medication.
Breast Cancer Screening (BCS)
The percentage of women 40-69 years of age who had a mammogram to screen for breast cancer.
Controlling High Blood Pressure (CBP)
The percentage of members 18 - 85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90).
Cervical Cancer Screening (CCS)
The percentage of women 21 - 64 years of age who received one or more Pap tests to screen for cervical cancer.
Comprehensive Diabetes Care (CDC)
The percentage of members 18 - 75 years of age with diabetes (type 1 and type 2) who had each of the following:
- Hemoglobin A1c (HbA1c) testing
- HbA1c poor control (>9.0%)
- HbA1c good control (<7.0%)
- Eye exam (retinal) performed
- LDL-C screening
- Medical attention for nephropathy
Childhood Immunization Status (CIS)
The percentage of children who had the following by their second birthday:
- four diphtheria, tetanus, and acellular pertussis (DTaP/DT)
- three polio (IPV)
- one measles, mumps, and rubella (MMR)
- three H influenza type B (HiB)
- three hepatitis B (Hepatitis B)
- one chicken pox (VZV)
- four pneumococcal conjugate (Pneumococcal conjugate)
Cholesterol Management for Patients with Cardiovascular Conditions (CMC)
The percentage of members 18 - 75 years of age who were discharged alive for acute myocardial infarction, coronary artery bypass graft, or percutaneous transluminal coronary angioplasty, or who had a diagnosis of ischemic vascular disease who had the following:
- LDL-C screening
- LDL-C control (<100mg/dl)
Follow-Up After hospitalization for Mental Illness (FUH)
The percentage of discharges for members 6 years of age or older who were hospitalized for treatment of selected mental health disorders and who had an outpatient visit, an intensive outpatient encounter, or partial hospitalization with a mental health practitioner. Two rates are reported:
- The percentage of members who received follow-up within 7 days of discharge
- The percentage of members who received follow-up within 30 days of discharge
Use of Imaging Studies for Low Back Pain (LBP)
The percentage of members with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of the diagnosis. A higher score indicates appropriate treatment of low back pain
Persistence of Beta-Blocker Treatment After a Heart Attack (PBH)
The percentage of members 18 years of age and older who were hospitalized and discharged alive with a diagnosis of acute myocardial infarction and who received persistent beta-blocker treatment for six months after discharge.
Prenatal and Postpartum Care (PPC)
This measure assesses two facets of prenatal and postpartum care:
- Timeliness of Prenatal Care. The percentage of deliveries that received a prenatal care visit in the first trimester or within 42 days of enrollment in the plan
- Postpartum Care. The percentage of deliveries that had a postpartum visit on or between 21 and 56 days after delivery.
Appropriate Treatment for Children With Upper Respiratory Infection (URI)
The percentage of children 3 months - 18 years of age who were given a diagnosis of upper respiratory infection (URI) and were not dispensed an antibiotic prescription. A higher rate indicates appropriate treatment of children with URI.